Jiang, Tao, Liping Zhao, Yanbo Yin, Huiqian Yu, and Qingzhong Li. Evaluation of middle ear function by tympanometry and the influence of lower barometric pressure at high altitude. High Alt Med Biol. 2270-76, 2021. Objective To evaluate middle ear function in residents of high-altitude areas in comparison to sea-level participants. Design Prospective observational study. Setting All experiments were performed by experienced audiologists with a calibrated tympanometry machine. Participants Young adults between the age of 17 and 23 were recruited. Seventy-five participants from Shanghai (altitude 4?m) and 133 participants from the Shigatse area (altitude 4,040?m) were recruited. Any participant with any otological disorder was excluded. Main Outcome Measure Four indexes of the tympanogram were evaluated in the two groups from different altitudes. Results Our results showed that the peak of static compliance for the participants in Shigatse was smaller, but the absolute compliance of tympanic membrane remained the same. Similarly, the ear canal volume (ECV) from tympanometry was also affected by the elevated altitude in Tibet. In addition, the tympanometric peak pressure was decreased in high-altitude residents, which suggests a slightly declined function of the Eustachian tube at lower barometric pressure. However, no difference was found in the tympanometric width (TW). Conclusion Our results indicate that tympanograms were affected by decreased atmospheric pressure at high altitude. Therefore, other than pressure-related indexes, TW is better for evaluating the function of the middle ear in high-altitude regions.Frontogenesis is the fluid-dynamical processes that rapidly sharpen horizontal density gradients and their associated horizontal velocity shears. It is a positive feedback process where the ageostrophic, overturning secondary circulation in the cross-front plane accelerates the frontal sharpening until an arrest occurs through frontal instability and other forms of turbulent mixing. Several well-known types of oceanic frontal phenomena are surveyed, their impacts on oceanic system functioning are assessed, and future research is envisioned.Surface temperature documents our changing climate, and the marine record represents one of the longest widely distributed, observation-based estimates. Measurements of near-surface marine air temperature and sea-surface temperature have been recorded on platforms ranging from sailing ships to autonomous drifting buoys. The raw observations show an imprint of differing measurement methods and are sparse in certain periods and regions. This review describes how the real signal of global climate change can be determined from these sparse and noisy observations, including the quantification of measurement method-dependent biases and the reduction of spurious signals. Recent progress has come from analysis of the observations at increasing levels of granularity and from accounting for artifacts in the data that depend on platform types, measurement methods, and environmental conditions. Cutting across these effects are others caused by how the data were recorded, transcribed, and archived. These insights will be integrated into the next generation of global products quantified with validated estimates of uncertainty and the dependencies of its correlation structure. Further analysis of these records using improved data, metadata, and methods will certainly uncover more idiosyncrasies and new ways to improve the record.Since 1995, 14 states have passed laws encouraging or mandating influenza vaccination for hospital workers. Although the Centers for Disease Control and Prevention recommends vaccinating health care workers to reduce disease transmission and patient risk, the effect of these laws on pneumonia and influenza mortality is unknown.
To measure the effect of state-level hospital worker influenza vaccination laws on pneumonia and influenza mortality.
Quasi-experimental observational study.
United States.
Population of all states from 1995 to 2017.
State adoption of a law promoting influenza vaccination for hospital workers.
Pneumonia and influenza mortality per 100?000 persons by state and by month, both population-wide and separately by age group, obtained from restricted-access National Vital Statistics System files. Linear and log-linear models were used to compare changes in mortality rates for adopting versus nonadopting states.
Implementation of state laws requiring hospitals to offer influenza vaccination to their employees was associated with a 2.5% reduction in the monthly pneumonia and influenza mortality rate (-0.16 deaths per 100?000 persons [95% CI, -0.29 to -0.02]; = 0.022) during the years when the vaccine was well matched to the circulating strains. The largest effects occurred among elderly persons and during peak influenza months.
Utilization of large-scale national data precluded analysis of more specific outcomes, such as laboratory-confirmed or hospital-acquired influenza.
State laws promoting hospital worker vaccination against influenza may be effective in preventing pneumonia- and influenza-related deaths, particularly among elderly persons. Vaccinating hospital workers may substantially reduce the spread of influenza and protect the most vulnerable populations.
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